Vision loss after inadvertent corneal perforation during lid anesthesia

Mansi Parikh, Young H. Kwon

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

A 68-year-old woman was referred for glaucoma management after inadvertent corneal perforation during eyelid anesthesia for upper eyelid blepharoplasty. A mixture of 50:50 2% lidocaine with 1:100,000 epinephrine and 0.5% bupivacaine buffered with sodium bicarbonate was injected intracamerally. Decreased vision and uncontrollable intraocular pressure resulted, despite prompt anterior chamber washout. Examination showed corneal edema, inflammation, and secondary angle closure. Intraocular pressure control with seton placement led to an improvement in vision; however, mild corneal haze remained, and specular microscopy showed endothelial cell loss, presumably secondary to local anesthetic toxicity. Inadvertent ocular penetration is a rare but serious complication of local eyelid anesthesia. Prompt recognition is essential to institute appropriate management and minimize subsequent vision loss.

Original languageEnglish (US)
JournalOphthalmic Plastic and Reconstructive Surgery
Volume27
Issue number5
DOIs
StatePublished - Sep 2011
Externally publishedYes

Fingerprint

Corneal Perforation
Eyelids
Anesthesia
Intraocular Pressure
Blepharoplasty
Corneal Edema
Sodium Bicarbonate
Bupivacaine
Anterior Chamber
Local Anesthesia
Lidocaine
Local Anesthetics
Glaucoma
Epinephrine
Microscopy
Endothelial Cells
Inflammation

ASJC Scopus subject areas

  • Ophthalmology
  • Surgery

Cite this

Vision loss after inadvertent corneal perforation during lid anesthesia. / Parikh, Mansi; Kwon, Young H.

In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 27, No. 5, 09.2011.

Research output: Contribution to journalArticle

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